Navigating Twists, Turns Of Ankle Sprains

November 30, 2020

Henry Ford Health System

Oh, how the ankle turns! If you’ve had a misstep or wrong turn result in a sprained ankle, you know how painful this injury can be. Henry Ford podiatric surgeon Paul Di Liddo, DPM, discusses ankle sprains and treatments.

Ankle Injury 101

From risk factors to treatments (and nearly everything in between), here’s what to know — and do — about ankle sprains.

Sprained Ankles Are Painfully Common

In fact, they’re among the most frequent injuries in the United States, with up to 25,000 people per day spraining their ankles. Although often associated with sports, ankle sprains can happen to anyone, anywhere. “I see ankle sprains from tripping over curbs, stepping in holes in a yard or simply walking,” says Dr. Di Liddo. “Ankle sprains — like accidents — happen.”

Ankle Sprains Injure Ligaments

“Ankle sprains occur when the ankle suddenly and forcefully twists or rolls past a point that the ankle ligaments can tolerate,” remarks Dr. Di Liddo. “The ankle ligaments will stretch or tear, either partially or completely.” An ankle can twist, turn or roll during a fall, jump or change of direction, while walking on uneven ground and more.

A Weak Ankle Is A Vulnerable Ankle

Most sprained ankles heal without long-term concern. In some cases, however, ligaments may not fully heal, resulting in a weak or unstable ankle. “A weak or unstable ankle can make an individual more susceptible to repeated ankle sprains,” explains Dr. Di Liddo.

High Arches Can Be Risky Business
People who have high-arched feet are more at risk of rolling — and therefore spraining — their ankles. So are people who have “loose joints,” because the ankle can overstretch with a seemingly minor twist. People who are at-risk for ankle sprains should take extra precautions when playing sports or performing other activities.

Some Sprains Can Be Treated At Home — Emphasis On Some
How you treat a sprained ankle depends on the severity of the injury. Minor sprains can be treated at home with the RICE method. The RICE method include:

 
  • Rest by avoiding use of the injured ankle
  • Ice applied to the ankle (without touching the skin) for no more than 20 minutes every three to four hours
  • Compression with an elastic bandage
  • Elevation above the heart

Ice, compress and elevate your ankle for the first few days. Rest and refrain from sports until ankle pain and swelling have subsided.

At-home treatments aren’t right for everyone — or every ankle injury. “A swollen ankle is typical if you have experienced a sprain,” says Dr. Di Liddo. “However, if you have severe ankle swelling, are in extreme pain or notice an odd ankle appearance, seek medical attention.” This is also true if you can’t walk more than a few steps or have limited ankle mobility. A foot and ankle specialist can diagnose your injury and begin treatment.

Ankle Treatments Abound

Ankle sprain treatments are designed to decrease pain and swelling, while protecting the ligaments from further injury. Treatments include wearing an ankle brace, walking boot or cast. Physical therapy to strengthen the ankle and maintain range of motion may also be incorporated after the ligaments have started to heal.

“Of course, for more severe injuries, a thorough physical exam and X-rays are necessary,” says Dr. Di Liddo. “This helps ensure that there is no other underlying injury, such as a fractured ankle or Achilles tendon rupture.”

Healing Times Vary

The recovery time for a sprained ankle depends on the severity of the injury. Sprains with minimal ligament stretching and no tear require one to three weeks. Partially torn ankle ligaments may take up to six to eight weeks to heal. A fully torn ligament can take several months to fully heal.

What To Do When Ankle Problems Persist

For people who continue to experience ankle instability, there are a host of options. “Physical therapy is the first step — but not the only one,” says Dr. Di Liddo. “If physical therapy has not been beneficial, we can discuss surgical approaches.”

Surgical options include:

  • Ligament repair or reinforcement via an outpatient procedure
  • Osteotomy, which is surgical cutting of bone, to lower arches when ankle instability is caused by high arches

For those with frequent ankle sprains or instability, a medical assessment is necessary and may include:

  • Physical exam
  • X-rays to assess bones and joints
  •  MRI to evaluate ankle ligaments

With this information in mind, you can prevent — or address — the twists and turns of ankle sprains.

Want to learn more? Henry Ford Health System sports medicine experts are treating the whole athlete, in a whole new way. From nutrition to neurology, and from injury prevention to treatment of sports-related conditions, they can give your athlete a unique game plan.

Visit henryford.com/sports or call (313) 972-4216 for an appointment within 24 business hours.

The Dangers Of Returning Too Soon After An Injury

When you've been hit with an injury, it's natural to want to get back to your regular activities as soon as possible. In fact, it's not uncommon for athletes to sidestep doctors' orders and return to the field or the court before an injury has healed.

"It doesn’t matter how much you train, or how much you prepare, injuries are going to happen, especially if you're an athlete," says Jamie Schwab, an athletic trainer at Henry Ford Health System. "But the real trouble arises when athletes try to play through their pain without allowing sufficient time for recovery."

Risks Of Returning Too Soon After Injury

If you sprain your ankle during a cross country run, it can be tempting to finish the race. Unfortunately, hiding your pain and powering through the activity can actually make matters worse.

"If you continue to work out after suffering from an injury, you run the risk of furthering that injury," Schwab says. So what began as a minor ankle sprain can evolve into a major sprain that sidelines you for weeks.

Returning to play after surgery demands extra precautions. "Athletes are a lot more susceptible to re-injury after returning from surgery, especially if they don't complete the entire 9-month or year-long rehabilitation protocol," Schwab says. In some cases, you can exacerbate an injury to such a degree that you'll never be able to participate in the same capacity.

A Safe Return To Play

The road back to play after an injury is a long and winding one. Before you can even consider returning to exercise, you need to reduce swelling, get pain under control and get your range of motion back to almost normal.

"The recovery process takes time," Schwab says. "But if you stick with it, and you take it seriously, it's going to be a whole lot easier for you to return to the playing field in a timely manner."

Once you get pain and swelling under control, you can focus on agility and weight exercises that will help you regain strength and slowly return to baseline. The key tenets for a safer return to play:

► Be honest about your abilities: "So many athletes are afraid to tell the truth," Schwab says. "But if you're hurting and you're not competing at your full potential, you're letting your team down and yourself down, too." Even worse, you could increase your risk of further injury.

Focus on building strength: Strength training is critical. It can help you become faster, stronger and more agile on the field. It can also help you recover more quickly after an injury.

Listen to your body: If something doesn't feel right, pay attention to it. Talk to your athletic trainer or a physical therapist to get to the bottom of what's bugging you and put a plan in place to address it.

Boosting Performance Over The Long Haul

Unfortunately, not every coach and athletic trainer stresses the importance of a maintenance program. In fact, focused training and maintenance exercises are key to preventing injuries in the first place.

"The rehabilitation exercises you begin doing on day one after injury need to be maintained at least three to four times each week, indefinitely," Schwab says. "If you follow that regimen, all of your muscular nagging strains will no longer be a problem because your body is constantly adapting to the stresses. It's conditioned, it's strong, it can withstand the constant changes in direction."

Most important, don't be afraid to try complementary strategies. Practice using a foam roller, try cupping to release tension in the muscles and enhance blood flow and consider getting a monthly massage.

Jamie Schwab, AT, ATC, SCAT, CSCS, is an athletic trainer with Henry Ford Sports Medicine and works with student athletes at Edsel Ford High School. She is a National Strength and Conditioning Association certified strength and conditioning specialist.

To find a doctor or athletic trainer at Henry Ford, visit henryford.com or call 1-800-436-7936.